The purpose of this study was to assess the influence of two shoe size conditions on foot pressure, ground reaction force (GRF), and lower extremity muscle fatigue. Seven healthy men participated. They randomly performed walking and running in two different conditions: proper shoe size and 10 mm greater than proper shoe size. Peak foot pressure, and vertical, anterior and mediolateral force components were recorded with the Parotec system and Kisler force platform. To assess fatigue, the participants performed treadmill running for twenty-five minutes twice, each time wearing a different shoe size. Surface electromyography was used to confirm localized muscle fatigue using power spectral analysis of four muscles (tibialis anterior, gastrocnemius medialis, rectus femoris, and biceps femoris). The results were as follows: 1) In walking conditions, there was a significantly higher peak pressure in the 10 mm greater than proper shoe size insole sensor 1, 2, 14, and 18 (p<.05). 2) In running conditions, there was a significantly higher peak pressure in the 10 mm greater than proper shoe size insole sensor 5, 14, and 15 (p<.05). 3) In walking conditions, there was a significantly higher first maximal vertical GRF in the 10 mm greater than proper shoe size (p<.05). 4) In running conditions, no GRF components were significantly different between each shoe size condition (p>.05). 5) Muscle fatigue indexes of the tibialis anterior and rectus femoris were significantly increased in the 10 mm greater than proper shoe size condition. These results indicate that wearing shoes that are too large could further exacerbate the problems of increased foot pressure, vertical GRF, and muscle fatigue.
The purpose of this study was to determine the relationship between activities of daily living and health-related quality of life in ambulatory stroke patients. This was a cross-sectional survey study of 60 patients who had survived one year or more after a stroke in community. Activities of daily living were assessed using the Functional Independence Measure (FlM) and health-related quality of life using the Stroke Impact Scale (SIS). The association between FIM and SIS was examined using Pearson' s correlation. The FIM score was higher than the SIS score. Most domains of FIM exhibited a high rate (45-85%) of ceiling effects. However, only the communication and memory domain of SIS exhibited of ceiling effects. The correlation coefficients were .835 (p<.01) for FIM-motor vs. SIS-ADL, .257 (p<,05) for FIM-motor vs. SIS-communication, .596 (p<.01) for FIM-motor vs. SIS-social participation, .635 (p<.01) for FIM-cognition vs. SIS-memory, .369 (p<.01) for FIM-cognition vs. SIS-ADL, and .289 (p<.05) for FlM-cognition vs. SIS-social participation. In conclusion, the correlation between FIM-motor and SIS-social participation was higher than that of FlM-cognition and SIS-social participation. The domains of emotion and hand function of SIS showed no correlation coefficients with FIM-total. To examine the activities of daily living and the quality of life in ambulatory stroke patients in community, it is necessary to use both the FIM and SIS.
The purpose of this study was to assess the effect of a group self exercise program in improving the quality of life regarding depression and the activities of daily living (ADL) of chronic stroke survivors, as well as the motor functions such as the 3 meter round walk, upper extremity function, and static balance. The subjects were 12 post-stroke ambulatory community center participants. All subjects participated in one 90 minute session per week for 7 weeks and received a home exercise program in every session. They had to record and submit an exercise check list. Quality of life was measured with the Beck depression inventory and the 8-Item Short-Form (SF-8). Motor functions were measured with the manual function test (MF'T), the kinesthetic ability trainer (KAT 3000), and the modified Barthel index. The level of depression decreased somewhat, but there were no significant differences after intervention. However, quality of life related health (SF-8) improved significant1y. There were significant improvements in the time for the 3 meter round walk, the functions of the affected upper extremities, and static balance and ADL (p<.05). The findings of this study suggest that a group self exercise program can improve quality of life related health and motor functions in stroke survivors.
This study was designed to examine the effects of temporary immobilization of the ankle and knee joints on standing in healthy young adults with the use of a postural control mechanism. The subjects were twenty-four college students (12 males and 12 females, aged between 20 and 28). A Biodex balance system SD 950-302 and its software were used to measure indirect balance parameters in standing. Each subject underwent postural stability tests in 4-different joint conditions: free joints, ankle immobilization only, knee immobilization only, and ankle and knee immobilization. In addition, the postural stability test was conducted once with the subject's eyes open and once with the eyes closed conditions. For data analysis of the postural stability tests, the overall stability index, antero-posterior stability index, and medio-lateral stability index were recorded. The overall stability index (p=.000) and medial-lateral index (p=.003) were significantly greater different conditions with eyes closed in postural stability. Therefore, the eyes closed condition is expected to be used as an effective postural stability training for treatment planning in patients with unstable postures. In addition, training based on the dynamic multi-segment model can improve postural stability and is available to therapeutic programs, helping people with unstable balance to reduce their risk of falling.
This study investigated gait characteristics, kinematics, and kinetics in the lower extremities between two different shoe conditions (high heeled shoes (7 cm), and high heeled shoes with a total contact insert (TCI)) after lower extremity muscle fatigue. Although TCI shave been applied in high heeled shoes to increase comfort and to decrease foot pressure, no study has attempted to identify the effects of TCI in fatigue conditions. The purpose of this study was to determine the effects of walking in high heeled shoes with TCI after lower extremity muscle fatigue was induced. This study was carried out in a motion analysis laboratory at Hanseo University. A volunteer sample of 14 healthy female subjects participated. All in fatigue conditions, the subjects were divided into two groups. The muscle fatigue was induced by 40 voluntary dorsi- and plantar-flexion exercises and 40 heel-rise exercises of the dominant foot. Surface electromyography was used to confirm the localized muscle fatigue using power spectral analysis of three muscles (tibialis anterior, gastrocnemius medialis and lateralis). The results were as follows: (1) In muscle fatigue conditions, the use of TCI decreased the peak flexion angle of the hip joint significantly in the early stance phase (p<.05) and increased the peak hip flexion moment in the terminal stance phase (p<.05). (2) In muscle fatigue conditions, the application of TCI also increased peak hip power generation in the early stance phase and peak hip power absorption in the terminal stance phase (p<.05). (3) In muscle fatigue conditions, the use of TCI reduced the impact force significantly and increased the secondary peak vertical GRF. These findings suggest that the TCI may provide beneficial effects when muscle fatigue occurs for a high heeled shoe gait. Future research employing the patient population and various types of TCI materials are required to clarify the effects of TCI.
The aim of the present study was to determine the effect of proprioceptive neuromuscular facilitation (PNF) leg patterns on the muscle activation of neck flexors. Twenty healthy subjects participated in this study. Each subject performed bilateral asymmetrical PNF leg patterns against manual resistance under four conditions: through the full range of motion toward the right side, left side, and the end range in the right side, left side. Electromyographic (EMG) data was collected from the sternocleidomastoid (SCM) muscles as neck flexors. The root mean square (RMS) value of the SCM was measured and normalized from maximal EMG activity of the SCM. The data were analyzed using the paired t-test and repeated analysis of variance (ANOV A) was used to compare the statistical significance. The results of this study are summarized as follows: Firstly, the RMS values of SCM were significantly higher in all four PNF leg patterns than in the resting condition (p<.05). Secondly, there was no significant difference in muscle activation according to the direction of PNF leg patterns (p>.05). Thirdly, there was no significant difference in muscle activation according to the point of range of the motion of leg patterns (p>.05). It is suggested that PNF bilateral asymmetrical leg patterns have a considerable effect on muscle activation of the SCM, regardless of the range of motion and direction of PNF bilateral asymmetrical leg patterns.
The purpose of the study was to investigate the effectiveness of self-paced walking exercises in elderly women with hypertension, hyperglycemia, and hypercholesterolemia. Thirty-eight elderly women with hypertension, hyperglycemia, and hypercholesterolemia (16 hypertension, 11 hyperglycemia, 11 hypercholesterolemia), aged between 65 and 80, were invited to participate in this study. Each subject participated in a self-paced walking exercise five times a week for twelve weeks from 26 June to 16 September 2006. The changes between pre- and post-exercise were analyzed using the analysis of a paired t-test with the SPSS version 12.0 package program. There were significant decreases in systolic blood pressure (p<.01) and diastolic blood pressure (p<.05), blood glucose(p<.05), and cholesterol in the blood (p<.01). These results show that self-paced walking exercises may be helpful in treating elderly women with hypertension, hyperglycemia, and hypercholesterolemia.
The aim of the study was to evaluate the effect of a disease-specific exercise (DSE) on temporomandibular joint (TMJ) function and neck mobility in TMJ dysfunction associated with ankylosing spondylitis (AS). Ten AS patients (seven males and three females) with TMJ dysfunction were recruited for this study. The DSE included exercises to correct head and neck posture and to improve the flexibility of the neck and TMJs. The patients attended treatment three times a week for 4 weeks, averaging 1 hour each session. Assessments were performed pretreatment, posttreatment, and 6 weeks after the completion of treatment. General physical status was assessed by four clinical measures (tragus-to-wall distance, modified Schober test, lumbar side flexion, and intermalleolar distance), the Bath ankylosing spondylitis function index (BASFI), and the Bath ankylosing spondylitis disease activity index. The main outcome measures included TMJ function (craniomandibular index (CMI)), and neck mobility (flexion, extension, rotation, and lateral rotation). None of the measures of general physical status, with the exception of BASFI, were significant1y different between the pretreatment, posttreatment, and 6-week follow-up (p>.05). However, CMI and all neck movements, except for extension, significant1y improved after the treatment (p<.05). These improvements were maintained during the follow-up period. The DSE used in the present study seems to be a clinical1y useful method for managing patients with symptoms from the stomatognathic system in AS. Further studies with more subjects and longer treatment times, including the follow-up period, will be conducted to validate these findings.
This study was designed to determine the effects of swimming and low power laser on rheumatoid arthritis in Sprague-Dawley rats. Rheumatoid arthritis was induced in 36 rats among 48 Sprague-Dawley rats by the subcutaneous injection of .05 ㎖ Freund's Complete Adjuvant into the right hind paw and .05 ㎖ Freund's Complete Adjuvant into the right hind knee joint capsule. A second injection was performed by the same method using .1 ㎖ Freund's Complete Adjuvant per a rat. Arthritic rats were divided into 8 groups: each 1 week and 2 weeks of arthritic swimming, arthritic laser, arthritic case control and normal group. In this study, several experimental tests were performed to determine the concentration of Interleukin-6, the space of the knee joint and the thickness of the hind paw. The concentration of Interleukin-6 and hind paw thickness decreased in the swimming group and laser group as compared to the control group. The space of the knee joint increased significantly after the swimming exercise. Swimming and low power laser therapy positively affect rheumatoid arthritis in rats affect by decreasing the concentration of Interleukin-6 and hind paw thickness, and increasing the space of the knee joint.
The self-report measure is a useful tool for evaluating self-recognized disability and difficulty in daily living activities. Although many studies and clinics used the Neck Pain and Disability Scale (NPDS) for measuring neck pain and functional impairment, there has not been much adaptation of this for use with Korean patients. The purpose of this study was to establish the reliability and validity of NPDS among Korean neck pain patients. Fifty-five subjects (32 males, 23 females) with neck pain enrolled in this study. They completed standardized self-administered questionnaires. The NPDS measures pain intensity; its interference with vocational, emotional, recreational, social, and functional aspects of living; and the presence and extent of associated factors. Reliability was determined by the intraclass correlation coefficient (ICC) and Cronbach's alpha for internal consistency. Validity was examined by correlating the NPDS scores to the Visual Analog Scale (VAS) score. The test-retest reliability of the translated versions of the NPDS was good ICC (2,1)=.86 (95%CI .76~.92). Cronbach's alpha value for NPDS was found to be .93, and this was statistically significant (p<.05). The criterion-related validity coefficient was .79 (p<.Oll. We conclude that the Korean version of NPDS has been shown to be a reliable and valid instrument for the assessment of neck pain. Successful linguistic and cultural translation will admit appropriate cross-cultural comparison for clinical analysis. Therefore, this study can be expected to be used as an adequate evaluation scale for neck pain related studies and treatments.
The Pediatric Balance Scale (PBS) is a modified Berg's Balance Scale developed as a balance measure for school-aged children with mild to moderate motor impairments. The purpose of this study was to determine the inter-examiner reliability of the Korean version of PBS when applied to children with developmental delays. In this study, PBS was administrated to a total of 79 children with developmental delays (17 with global developmental delay, 31 with cerebral palsy, and 31 with mental retardation) in the Seoul Community Rehabilitation Center. Two pediatric trained physical therapists with longer than 13 year of clinical experience scored the children's performance blind, while replaying videotaped data. The inter-examiner reliability was statistically determined by intraclass correlation coefficients (ICCs). The results of this study revealed that the Korean version of PBS seems to have high inter-examiner reliability when applied to children with movement disorders such as global developmental delay (ICC=.96) and cerebral palsy (ICC=.97); however, it has relatively lower inter-examiner reliability (ICC=.78) for children with developmental delay secondary to mental retardation. therefore, the results support that the Korean version of the PBS could be a useful clinical measurement to assess the balance skills for children with developmental delay who have an adequate level of cognition to enable them to fol1ow the verbal instructions to complete the test.